Newspaper article Charleston Gazette Mail

SAVVY SENIOR ; Automatic Medicare Advantage Enrollment Causes Confusion

Newspaper article Charleston Gazette Mail

SAVVY SENIOR ; Automatic Medicare Advantage Enrollment Causes Confusion

Article excerpt

Dear Savvy Senior: I'll be 65 in a few months and I recently pre- enrolled in original Medicare. But last week, I received a member card in the mail for a Medicare Advantage plan that I did not enroll in. What's going on? Medicare is so confusing with all the different choices, and now it seems like I'm getting automatically enrolled in a plan I didn't even choose. Is this a scam? - New to Medicare Dear New:It's not a scam, but it is a growing problem the Centers for Medicare and Medicaid Services needs to resolve. Here's what you should know.

Automatic Enrollment

When Americans first become eligible for Medicare - typically at age 65 - they can choose to enroll either in original Medicare, or they can opt for a Medicare Advantage plan, which is offered by private insurance companies. But some people, like yourself, are being enrolled in a Medicare Advantage plan without your knowledge.

Here's how it's happening.

Before becoming eligible for Medicare, many people are covered by a commercial or a Medicaid health care plan run by a private health insurance company. These insurers often operate Medicare Advantage plans too.

Under a little-known rule authorized by the federal government, some insurers can shift their beneficiaries who are turning 65 to their own Medicare Advantage plan. It's a process called "seamless conversion enrollment, and all it requires is that the insurance company send a letter to the beneficiary explaining the new coverage, which takes effect unless the member opts out within 60 days. The idea is to preserve continuity for those who want to stay with the same company.

But some seniors are unaware that they've been signed up, in part due to the flood of mail they get around their 65th birthday from insurers marketing their Medicare plans. This makes it easy to miss a notice of seamless conversion or fail to understand the letter.

It can also have serious financial consequences. Medicare Advantage plans tend to be HMOs and PPOs with limited provider networks. …

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